一个Pembrolizumab诱导过敏性肝炎的病例报告
Saho Nakatani1, Munehisa Fukushima2, Shiro Akahani3
1Otolaryngology and Head and Neck Surgery, Kansai Medical Hospital, Toyonaka, JPN.
Cureus
|August 19, 2024
概括
布罗利祖马布是首线治疗头癌的药物,可导致罕见的肝损伤. 这一案例凸显了在患有肝功能障碍的患者中考虑布罗利祖马布诱导的过敏性肝炎的重要性.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 布罗利祖马布是治疗复发性或转移性头角状细胞癌的标准一线治疗方法.
- 虽然免疫检查点抑制剂通常耐受良好,但像 pembrolizumab 这样的免疫检查点抑制剂可能会导致免疫相关的不良事件,包括肝损伤.
研究的目的:
- 报告发生在 pembrolizumab 加上化疗后不久发生的急性肝损伤病例.
- 强调接受pembrolizumab的患者肝损伤的诊断考虑因素.
主要方法:
- 一个48岁的妇女的病例报告,患有复发的头部和部状细胞癌,接受了 pembrolizumab 加上化疗治疗.
- 监测肝功能测试 (阿酸胺转移酶,阿斯巴酸胺转移酶) 和淋巴细胞转化测试.
主要成果:
- 在 pembrolizumab 加上化疗开始后两天,患者肝酶显著升高.
- 药物停用后两周内肝功能正常化;淋巴细胞转化测试仅对pembrolizumab呈阳性.
- 这些发现表明布罗利祖马布诱导的过敏性肝炎.
结论:
- 临床医生应考虑在出现肝损伤的患者中考虑 pembrolizumab 诱导的过敏性肝炎.
- 及时诊断和取消侵权剂可以导致肝功能恢复.
- 区分药物诱导的肝损伤与肝转移等其他原因至关重要.
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